EyeWorld Asia-Pacific September 2020 Issue

EWAP SEPTEMBER 2020 17 FEATURE that delivers light energy to soften blockages of the meibomian glands. Results are maximized when combined with microblepharoexfoliation, she said. Dry eye and premium lenses Dr. Trattler said that premium lenses, especially presbyopia- correcting lenses, can be sensitive to residual astigmatism. Physicians have to be sure that they are getting accurate measurements so that the optimal lens power is selected, he said. This typically requires aggressive treatment of MGD and dry eye first to obtain good measurements. Dr. Trattler also mentioned the Light Adjustable Lens (RxSight), where the measurements and in-lens refractive treatments are done 3–4 weeks after surgery. For patients that receive these lenses, it’s important to pretreat and optimize their ocular surface and continue this treatment until the lens power is locked in. “Especially for patients who are paying out of pocket for a premium lens, we need to nail that refractive outcome, otherwise we’re going to have an unhappy patient,” Dr. Matossian said. Their expectation is beyond perfect because they’re paying thousands of dollars, she added, so tuning up the surface to get more reliable information is important, especially in a subset of patients seeking less dependence on spectacles. If they have very severe dry eye Visually significant corneal staining is common prior to cataract surgery, but patients are often asymptomatic. Source: Christopher Starr, MD disease with an underlying chronic medical condition, they may not be a candidate for a presbyopia-correcting implant, and they would have to be educated as to why they’re not a good candidate, Dr. Matossian said. EWAP References 1. Gupta PK, et al. Prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation. J Cataract Refract Surg. 2018;44:1090–1096. 2. Trattler WB, et al. The Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO) study: the effect of dry eye. Clin Ophthalmol. 2017;11:1423–1430. 3. Starr CE, et al. An algorithm for the preoperative diagnosis and treatment of ocular surface disorders. J Cataract Refract Surg. 2019;45:669–684. Editors’ note: Dr. Epitropoulos is clinical assistant professor of ophthalmology, The Ohio State University, Columbus, Ohio, and has relevant interests with Novartis, Allergan, Sun, Johnson & Johnson Vision, PRN, and BlephEx. Dr. Matossian practices at Matossian Eye Associates, Doylestown, Pennsylvania, and has relevant interests with Johnson & Johnson Vision, Quidel, TearLab, Bruder, PRN, and BlephEx. Dr. Starr is associate professor of ophthalmology, Weill Cornell Medicine, New York, and has relevant interests with Allergan, Novartis, Alcon, Johnson & Johnson Vision, Dompe, BlephEx, Bruder, TearLab, Quidel, Sun, Kala, and Eyevance. Dr. Trattler is Director of Cornea, Center for Excellence in Eye Care, Miami, Florida, and has relevant interests with Allergan, Novartis, Sun, Sight Sciences, Johnson & Johnson Vision, Bausch + Lomb, NovaBay, and Alcon. www.haag-streit.com Artificial intelligence with Hill-RBF IOL data from all over the world collected by leading cataract surgeons is the foundation for the Hill-RBF. This big data is analyzed by pattern recognition based on artificial intelligence leading to highly accurate IOL predictions and providing confi- dence thanks to a unique reliability check. Hill-RBF 2.0 The new version of RBF is based on a bigger dataset consis- ting over 3x the amount of data compared to the previous version. This leads to an impressive outcome of 94.8% within ±0.5 D in all eyes*. In addition the Hill-RBF was complemen- ted with the well-established Abulafia-Koch algorithm for torical applications. * n = 288 / Clinical Study: Sperical Equivalent Results, Steven V. Scoper, Satelite Symposium, ASCRS 2017 LENSTAR 900 AI powered IOL calculation